Analysis of the Clinical Status and Treatment of Facial Cellulitis of Odontogenic Origin in Pediatric Patients

Selected Saliva-Derived Cytokines and Growth Factors Are Elevated in Pediatric Dentofacial Inflammation

Dentofacial inflammation resulting from untreated dental caries is a serious disease that can spread to deeper tissues of the neck and face. This study aimed to analyze salivary cytokine profiles as potential biomarkers of acute odontogenic infections in children. The study group consisted of 28 children aged 3-17 years old with acute dentofacial infections (DI) and a control group (caries experience, CE) of 52 children aged 4-17 years old with uncomplicated dental caries. The cytokine profile was analyzed using the Bio-Plex Pro Human Cytokine 27-Plex kit in the saliva of children in both groups. The levels of IL-4, IL-15, FGF-2, G-CSF, and PDGF-BB were significantly increased in children with dentofacial infections compared to the control group. In contrast, the levels of other cytokines, such as IL-2, IL-7, IL-9, IL-13, GM-CSF, and IFN-γ, did not show statistically significant differences between these two groups. IL-4, IL-15, FGF-2, G-CSF, and PDGF-BB may serve as potential selective biomarkers of inflammation of the oral cavity in children. These biomarkers can be useful in identifying and monitoring the progress and treatment of bacterial infections resulting in dentofacial inflammation.

Pediatric Odontogenic Infections

Odontogenic infections are a broad group of head and neck conditions that arise from the teeth and surrounding periodontium. These largely preventable infections disproportionately affect members of ethnic and racial minorities and low-income/uninsured groups, and result in significant costs to our health care system. Left untreated, odontogenic infections can spread to deep spaces of the head and neck and can result in life-threatening complications. The mainstay of treatment includes timely treatment of the affected teeth. These infections are a global public health concern that could be diminished with improved access to routine dental care.

Saliva-Based Protein Analysis in Pediatric Dentofacial Inflammation

Aim

Saliva contains various proteins that are important in developing inflammatory processes and their prevention. One key aspect of saliva research is the relationship between oral infections and inflammation, and the role of some salivary proteins.

The Work Aims

To demonstrate which salivary cytokines can be biomarkers of acute odontogenic oral and facial infections in children.

Material and Methods

The study included two groups of patients: a study group of 28 children: 7 girls and 21 boys aged 3 -17 years with acute dentofacial inflammation (DI) and a control group of 52 children: 16 girls and 36 boys aged 4-17 years with uncomplicated dental caries (CE). The levels of Interleukin-5 (IL-5), Interleukin -10 (IL-10), Interleukin-17A (IL-17A), Interleukin-12p70 (IL-12p70), Eotaxin, Rantes, Vascular Endothelial Growth Factor (VEGF), and Interferon gamma-induced protein 10 (IP10) in the saliva of children in DI and CE groups were compared. Statistical analysis was performed with Statistica 13. The Student's t-test and the Wilcoxon signed-rank test were used.

Results

The results show that IL-10, IL-17A, and Eotaxin showed a statistically significant increase in the DI group compared to the CE group. The significance level for IL-10 was p=0.02, for IL-17A was equal to Eotaxin and p=0.04. The other measured parameters did not differ statistically significant between the two groups.

Conclusion

IL-10, IL-17A, and Eotaxin can be used as potential biomarkers for tooth-related inflammatory states of the oral cavity and face in children. These biomarkers can be useful in identifying and monitoring the presence of inflammation in the oral cavity and face.

Facial Cellulitis and Skin Abscess: A Case of a Simple Bone Cyst in the Mandibular Bone

Cellulitis, abscess, or both are among the most common skin and soft tissue infections. Typically, cellulitis arises due to bacterial penetration through breaches in the skin's protective barrier. However, in cases of facial cellulitis, it is necessary to consider not only the breakdown of the skin barrier but also to differentiate odontogenic cellulitis. A prompt and accurate diagnosis of facial infections stemming from dental issues, coupled with the administration of antibiotics and dental interventions, played a crucial role in resolving this condition. Odontogenic cellulitis often develops as a result of dental caries. However, we experienced a case of odontogenic cellulitis and skin abscess occurring due to a simple bone cyst in the mandible, even in the absence of dental caries. Proper imaging examinations are crucial for diagnosis.

Mortal condition in an unusual localization, analysis of isolated tongue and tongue base abscesses

BACKGROUND

Tongue abscess (TA) is a very rare clinical condition and its treatment is very important. Surgical drainage is at the forefront in the treatment. Our study includes patients with tongue and tongue base abscesses.

AIM

To discuss the clinical and laboratory findings of these patients emphasizing the underlying causes and treatment options with the largest patient series in the English literature.

METHODS

We included patients with isolated TA who applied to our clinic between January 1, 2020 and January 1, 2023. Those who lack the recorded data, those who are not between the ages of 18-66, those who have not undergone surgery-interventional procedure, and those who have infection and/or abscess in another place were excluded from the study.

RESULTS

There were two female (18%) and nine male (82%) patients in our series consisting of 11 patients. Their ages ranged from 18 to 66, and the mean ± SD was 48.63 ± 16.3. Considering the localization of the abscess, three anterior abscesses (27%), two lateral abscesses (18%), and six abscesses at the base of the tongue (54%) were detected.

CONCLUSION

Tongue abscesses can cause acute upper airway obstruction and respiratory collapse. It may be necessary to act quickly for the tracheotomy procedure and this procedure can usually be performed under local anesthesia as intubation cannot be achieved. When we encounter an abscess in an unexpected organ, difficulties may be encountered in the management of the patient.